Page 12 - Waterjet Holdings- OE Guide 2015

Closed
Open
Schedule of Fractures Reduction Reduction
Hip $4,000 $8,000
Thigh (femur) $4,000 $8,000
Pelvis $3,200 $6,400
Leg $2,400 $4,800
Bones of the face or nose $1,200 $2,400
Upper jaw, maxilla $1,400 $2,800
Upper arm (elbow to shoulder) $1,400 $2,800
Lower jaw, mandible $1,600 $3,200
Shoulder blade $1,600 $3,200
Kneecap (patella) $2,000 $4,000
Hand/wrist $2,000 $4,000
Forearm $2,000 $4,000
Foot (except toes) $2,000 $4,000
Coccyx $320 $640
Ankle $2,000 $4,000
Collarbone (clavicle) $1,600 $3,200
Rib $320 $640
Finger/toe $320 $640
Open
Closed
Schedule of Dislocations Reduction Reduction
Hip $3,000 $6,000
Knee (not kneecap) $1,950 $3,900
Ankle or foot $1,200 $2,400
Lower jaw $900 $1,800
Shoulder $1,500 $3,000
Hand (other than ingers) $1,050 $2,100
Elbow $600 $1,200
Wrist $750 $1,500
Finger/toe $240 $480
Additional Beneits
Burns (second and third Degree) $100 to $20,000
Concussion $200
Coma $10,000
Ruptured disc (with surgical repair) $400 ($100 in irst year of policy)
Lacerations $25 to 400
Open abdominal surgery $1,000
Blood/plasma/platelets $100
Knee cartilage—torn/exploratory $400 ($100 in irst year of policy)
Lodging (per night) $100
Transportation $150 (bus)/$300 (train or plane)

Waterjet Holdings 12